经皮冠状动脉介入术前应用高负荷量氯吡格雷的近期疗效观察  

The short-term curative effects of high loading dose of clopidogrel before percutaneous coronary intervention operation

作　　者：张杰[1] 高苓[1] 张明明[1] 朱善香[1] 王菲[1] 

机构地区：[1]解放军第八十八医院心内科,山东泰安271000

出　　处：《西部医学》2014年第3期341-344,共4页Medical Journal of West China

摘　　要：目的观察和分析经皮冠状动脉介入(PCI)术前应用高负荷剂量氯吡格雷的近期疗效和副反应情况。方法选取拟行PCI术的患者100例作为研究对象,并将其随机分为观察组和对照组各50例。观察组患者术前给予600mg高负荷剂量氯吡格雷进行预治疗,对照组患者术前给予300mg常规负荷剂量氯吡格雷进行预治疗。对两组患者服药后16、36h的血小板最大凝集率降低度(△MPAR)进行检测和比较,并对两组患者术后30天和6个月发生主要临床心血管事件和出血事件的情况进行随访和观察。结果观察组患者在服药后16小时的△MPAR显著高于对照组(P<0.05);术后30天和6个月观察组患者临床心血管事件的发生率均显著低于对照组(P<0..05);术后6个月,观察组患者发生活动后胸闷和再入院比例显著低于对照组(P<0.05);术后30天和6个月,两组患者发生各项出血事件比例及总发生率的差异均无显著性(P>0.05)。结论 PCI术前应用高负荷剂量氯吡格雷可有效抑制血小板的聚集,降低心血管事件的发生率,具有更加显著的近期疗效,且副反应与常规负荷量基本相当。Objective To observe and analyze the short-term curative effects and the adverse reactions of high load- ing dose of elopidogrel before percutaneous coronary intervention （PCI） operation. Methods 100 cases of the patients undergo PCI were randomly divided into the observation group and the control group. 50 cases were included into each group. The patients in the observation group were pretreated with 600mg high loading dose of clopidogrel, while the pa- tients in the control group were pretreated with 300mg conventional loading dose of clopidogrel. The decreases of the maximum platelet agglutination rate （△MPAR）of 16h, 36h after taking the drug of the patients in the two groups were detected and compared, and the clinical cardiovascular events and the bleeding events of the patients in the two groups in 30d and 6 months after the operation were followed up and observed. Results The △MPAR of the patients in the obser- vation group in 16h after the treatment was significantly higher than that in the control group （P〈0. 05） ; in 30d and 6 months after the operation, the occurrence of cardiovascular events of the patients in the observation group was signifi- cantly lower than that in the control group （P〈0.05）. In 6 months after the operation, the proportions of the patients with chest stuffy after activities and readmission in the observation group were significantly lower than those of the con- trol group （P〈0.05） ;in 30d and 6 months after the operation, there were no significant differences of the proportions of the patients with various bleeding events and the total incidence rate between the tow groups （P~〉0. 05）. Conclusion The application of high loading dose of clopidogrel before PCI operation can effectively inhibit the platelet aggregation, reduce the incidence of cardiovascular events and achieve more significant short-term curative effects. The adverse reac- tions of the application are equal to the aapplication of the conventional loading dose.

关 键 词：氯吡格雷 经皮冠状动脉介入术 疗效观察 

分 类 号：R541.4[医药卫生—心血管疾病]